| | | | | Sponsored by Pharmaceutical Care Management Association | View in Browser | | |  | | | | | | Welcome to Overnight Health Care, sponsored by the Pharmaceutical Care Management Association. It’s a recess Monday in Washington, where we highly encourage you to go outside. We insist: Read this newsletter outside. With Congress out of town, we'll first head to the states where Medicaid expansion is all the rage today. Let's start in Maine. A group instrumental in getting Medicaid expansion on the ballot — and approved — in Maine is taking Gov. Paul LePage (R) to court. Maine Equal Justice Partners is seeking to compel LePage’s administration to begin implementing a Medicaid expansion program, filing a lawsuit in conjunction with other organizations and individuals. The group gathered outside Maine's state courthouse on Monday to announce their suit. Key quote: “The governor has continued to drag his feet," Robyn Merrill, MEJP’s executive director, said at their press conference. “We don’t know what’s going to happen with the legislature. They still have the opportunity to act on Medicaid expansion, but that hasn’t happened yet. And so with the goal of getting health care to people as soon as possible, we decided we couldn’t wait any longer.”
Context: Nearly 60 percent of state voters backed Medicaid expansion at the polls in November. LePage, though, is a staunch opponent of Medicaid expansion. Case in point: The term-limited governor vetoed expanding the ObamaCare program five times while in office. He maintains that lawmakers can’t raise taxes or take money from the rainy day fund to implement the law, which nearly 60 percent of voters approved at the ballot box in November. Interesting nugget: The state’s Democratic attorney general, Janet Mills, is a candidate in the governor’s race. Her office declined to comment. The big picture: Other states are also looking to put Medicaid expansion on the ballot and will be watching the lawsuit closely. Read more here. | | | |  | | | | | | | | SPONSORED CONTENT | | |
Pharmaceutical Care Management Association Pharmacy benefit managers (PBMs) are hired by employers, unions, and government programs to negotiate aggressive discounts from drug companies and drugstores. PBMs continue to keep overall spending and out-of-pocket costs down despite massive price hikes by drugmakers. Learn how PBMs are part of the solution to reducing Rx costs at DrugBenefitSolutions.com. | | | | | | |  | | | | Meanwhile in Idaho: Idaho is one of the states poised to follow Maine’s lead by allowing a Medicaid expansion ballot measure in November. An activist group called Reclaim Idaho said it has collected the 56,192 signatures necessary to put the expansion question onto the ballot. County clerks will need to verify the signatures by June 30. The initiative would expand Medicaid coverage for more than 60,000 Idahoans. Those people are currently in a state of limbo: they earn too much to qualify for Medicaid, but not enough to qualify for subsidized insurance on the state’s exchange.
Maine was the first state to put Medicaid expansion to a vote. So far this year, Idaho and Utah have already collected enough signatures to put expansion on their respective ballots. What’s different: In Idaho, lawmakers and the governor have the power to change or overturn a voter-passed initiative. It’s just like any other law. What are the odds: If the initiative passes, at least one GOP gubernatorial candidate said he’d consider fighting it. Rep. Raul Labrador, currently a member of the conservative House Freedom Caucus, said during a debate he wants people to know the true cost of Medicaid expansion. He hinted that the initiative wouldn’t even pass if people knew what they were voting for. Read more here. A bipartisan group of senators has a message to the Trump administration: Don’t place Medicaid work requirements on tribes. The administration told tribal leaders in January in a letter that it was unable to require states to exempt American Indians and Alaska Natives from Medicaid work requirements because it is "constrained by statute." Such exemptions would be an illegal racial preference, the administration argues. The senators, led by Tom Udall (D-N.M.), argue not exempting tribes would violate federal law and court decisions that state tribes are not a racial group but political communities. Read more here. | | | |  | | | | | | Moving on from Medicaid... Groups and state officials around the country working to stop teen pregnancy are alarmed. The Trump administration's new guidelines for these groups have them worried they might have to scrap programs they have been working on for years. The administration is shifting the focus of the Teen Pregnancy Prevention Program (TPPP) more toward abstinence education, and groups will have to get onboard if they want to continue receiving financial support from the federal government For some grantees, these requirements could clash with laws in their states, and with the approaches they have decided are best suited to addressing teen pregnancy rates in their communities. Other grantees, like Hennepin County in Minnesota, will have to look for other funding options outside the federal government to continue a program it says has reduced teen pregnancy rates by 66 percent since 2008. Key quote: “Why would we change the use of such highly effective programs that work well, to go to something that is abstinence-based and that you can find plenty of research that it doesn’t work?” asked Kathleen Wick, program manager for Hennepin County’s teen pregnancy prevention program, called “Better Together Hennepin.” Read more here. Back in Washington...CDC director will get a pay cut. The Department of Health and Human Services on Monday confirmed that CDC Director Robert Redfield will have his $375,000 annual salary reduced. But the agency didn’t say what his new salary will be. A spokesperson for HHS said Redfield asked for a pay cut because he didn’t want to have his compensation “become a distraction.” The backstory: Redfield’s request came just days after Sen. Patty Murray (D-Wash.) publicly asked HHS to justify the salary. Redfield was earning more than twice as much as his predecessors because he was hired under a special program called Title 42, which was created to draw in health scientists with rare and critical skills to government work. This could have been awkward: Redfield was also earning more than his boss, HHS Secretary Alex Azar. Azar’s salary is set by law. Key quote from the letter: “It is difficult to understand why someone with limited public health experience, particularly in a leadership role, is being disproportionately compensated for his work as compared to other accomplished scientists and public health leaders in comparable roles within the federal government.” Read more here. | | | |  | | | | | | | | SPONSORED CONTENT | | |
Pharmaceutical Care Management Association A drug company’s decision to increase the price of a forty-year-old drug by 1400% – despite no change in the supply chain – undermines drugmakers’ attempt to blame their prices on the insurers, pharmacies, PBMs, and wholesalers through which patients access medicines. Drugmakers set prices like any other company – according to whatever the market will bear, regardless of underlying costs or the rebates they negotiate with PBMs and health plans. | | | | | | |  | | | | What we’re reading Molina Healthcare says its 2018 profits in places where it still offers ObamaCare plans "exceeded expectations," according to a report from Forbes. Megan McArdle in an op-ed for the Washington Post looks at the debate over whether new short-term health plans will undermine ObamaCare. Bill Gates says he spoke to President Trump about developing a universal flu vaccine. Gates claimed Trump was "super interested" in an interview with Stat News. State by state The wife of West Virginia Attorney General Patrick Morrisey (R) lobbied federal lawmakers on issues for an opioid wholesaler, according to a report from the Charleston Gazette-Mail. The Washington Post looks at cities that want to open supervised injection facilities. There's a catch though -- Such facilities are currently illegal in the U.S. Transgender residents are suing over a Wisconsin Medicaid rule that denies them coverage for gender reassignment surgeries, reports the Associated Press. | | | | | | | | | | | | | | | | | | | | | | Did a friend forward you this email? | | | | | | | | | | | | | |
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